Retinal detachment

Our eyes are prone to abnormal phenomena and some diseases are also common, especially among the elderly. Some eye diseases are particularly common. Do you know about retinal detachment? There are many reasons that can lead to retinal detachment. The incidence of this disease is very high among middle-aged and elderly people, and it has a lot to do with genetics and external factors.

Retinal detachment will cause the image presented to our eyes to be incomplete or even completely missing. There are many types of retinal detachment, including primary and secondary. If such a phenomenon occurs, it must be treated as soon as possible to avoid more serious damage to the eyes.

Retinal detachment

1 Causes

There are many causes of retinal detachment. Rhegmatogenous retinal detachment is more common in middle-aged or elderly people, most of whom are myopic, and can affect both eyes one after the other. The causes of the disease include lattice and cystic degeneration of the peripheral retina, vitreous liquefaction and retinal adhesion, which are related to age, heredity, trauma and other factors. Tractional retinal detachment is more common in proliferative diabetic retinopathy, ocular trauma, long-term vitreous blood, retinal periphlebitis, multiple intraocular surgeries, long-term retinal detachment, condensation, etc. Exudative retinal detachment is more common in intraocular retinal choroidal tumors such as retinal angioma, retinoblastoma, choroidal melanoma and metastatic carcinoma; inflammation such as uveitis, VKH, choroiditis, scleritis; pigment epithelial lesions such as bullous retinopathy, uveal leakage syndrome; retinal vascular diseases such as von-Hippel and coats disease; systemic diseases such as pregnancy-induced hypertension, hypertensive retinopathy and some blood diseases.

2. Classification

There are many methods for retinal classification. According to the mechanism of disease, retinal detachment can be divided into rhegmatogenous, tractional and exudative. Retinal detachment is divided into partial and complete types according to the extent, and into primary and secondary types according to the cause.

1. Primary retinal detachment

Primary retinal detachment, also known as rhegmatogenous retinal detachment, is a condition in which the fluid in the vitreous cavity enters the subretina through a retinal tear, causing separation of the neuroepithelium and pigment epithelium. Such patients often suffer from retinal degeneration, atrophy, and thinning due to certain factors such as high myopia and advanced age, or have high myopia, vitreous liquefaction, detachment, condensation, and adhesion to the retina.

2. Secondary retinal detachment

The cause of secondary retinal detachment is relatively clear. It is caused by other eye diseases or certain systemic diseases, such as exudative retinitis, acute diffuse choroiditis, pregnancy-induced retinopathy, etc. A large amount of exudate accumulates under the retina, causing retinal detachment. After certain eye injuries or vitreous hemorrhage caused by retinal perivenitis, the organized and proliferating vitreous cords pull the retina down. Some choroidal tumors or subretinal parasites can push up the retina and cause retinal detachment. Systemic diseases such as diabetic vitreoretinopathy can cause detachment of the retina due to vitreous proliferation pulling on the retina.

There are also some special eye diseases that cause retinal detachment, such as congenital choroidal coloboma and Marfan syndrome, which are all related to congenital maldevelopment of the fundus.

3 Clinical manifestations

When a partial retinal detachment occurs, the patient will experience a fixed, cloudy shadow in the visual field on the opposite side of the detachment. If macular detachment occurs, central vision will drop dramatically. The detachment is often preceded by aura symptoms, with flashes of light appearing during eye movement. Due to the opacity of the vitreous body, dark shadows often float in the field of vision. If the retina is completely detached, vision may be reduced to light perception or completely lost. Before vision loss, there is often distortion of vision and a feeling of tremor when the eye moves. Because more intraocular fluid enters the choroid through the pigment epithelium, the intraocular pressure is low. The wider the detachment area and the longer the duration, the lower the intraocular pressure. Occasionally there are cases of elevated intraocular pressure. Small white spots may be seen behind a retina that has been detached for a long time. When the retina is reattached and the subretinal fluid is absorbed, intraocular pressure can be restored.

The symptoms of retinal detachment are generally very obvious. The eyes will become blurred and vision will drop sharply. If retinal detachment occurs, you must have an eye examination in time to see what caused it, whether it is primary or acquired. Eye health is very important to us, and everyone must care about their own health.